Founded in 1933, the International Rescue Committee (IRC) responds to the world’s worst humanitarian crises and helps people to survive and rebuild their lives. At work today in more than 40 countries, the IRC restores safety, dignity and hope to millions who are uprooted and struggling to endure. The IRC leads the way from harm to home.

The Syria crisis is often described as the worst humanitarian catastrophe since the end of the Cold War. Inside Syria, 7.6 million people are internally displaced and 12.2 million are in need of humanitarian assistance, with 4.8 million in hard-to-reach areas. There are 4 million Syrian refugees in neighboring countries. This is no short-term humanitarian episode. The devastating human consequences to huge numbers of people will endure for decades. The destruction of relationships, communities, livelihoods, homes and infrastructure will take years to repair.

Now in its sixth year, the armed conflict in Syria has resulted in a humanitarian crisis inside Syria and throughout the region. The most recent figures indicate that over 5 million Syrian refugees in neighboring Turkey, Lebanon, Jordan, and Iraq. The United Nations High Commissioner for Refugees (UNHCR) reports that 654,903 refugees were registered in Jordan.

Working in coordination with the humanitarian community and the Government of Jordan, the IRC provides assistance for Syrian refugees in both camp and urban settings. The IRC's assistance programs are focusing on providing health, protection and economic empowerment services at the urban areas in Mafraq and Irbid governorates and inside the two camps.

Consultancy work Background:

The health sector continues to struggle with a funding gap in face of increasingly unmet needs. In 2017, 34% of the total requested funds under health sector went uncovered, amounting for $27,670,397. This shortfall in funding severely affected the Syrian refugee population in Jordan and the amount of health assistance available to them. On November 2014, the government of Jordan announced that Syrian refugees will no longer receive free treatment in public health facilities, and introduced a user fee, ranging from 35% to 60% of what non-Jordanians pay.

A recent Ministerial Council decision in 2018 require Syrians to cover expenses at 80% of the foreigner’s rate. These decisions, driven by fiscal gaps, constitute the most significant barrier to Syrian refugees’ access to services, given that the vast majority of them live under the poverty line and do not have the means to cover the cost of health in government facilities. Financial costs as well as legal documentation issues are increasingly funneling Syrian refugees toward free-of-charge humanitarian organizations who are unable to meet the demand. While INGOs attempted to fill the gap, lack of funding and proper multiyear funding streams, left many unable to meet the increasing demands on health services.

In response to the new MoH decision the IRC’s started to collect and analyze data received through different systems to understand the situation on ground. Since March 2018, the IRC has conducted the following:

– Tracked all patients who accessed urban static clinics but were unfortunately turned away because of reaching the maximum capacity of seeing patients at the IRC’s clinics for the day.

– All communications received through the feedback and complaint mechanism were analyzed to review the trends of requesting assistance before and after the decision.

-A customized exit survey was developed targeting the IRC’s health patients to understand whether the decision is affecting them and to what extent.

2.Explore the available options for Syrian refugees to receive health services and medication.

3.Understand the access to health services, current attitudes towards seeking health services and practices among the interviewed Syrian refugees.

4.Understand the coping mechanisms adopted by the interviewed refugees to manage their health needs.

To reach aim of this consultancy assignment, the consultant will:

1.Provide the IRC with preliminary findings of collected data through the different channels.

2.Collect further qualitative data from stakeholders and IRC’s beneficiaries and community level health services’ seekers who are not using the IRC’s clinics to enrich the preliminary findings.

3.Prepare a report with findings and recommendations that can be used for advocacy purposes.

4.Provide the IRC with recommendations on how to better monitor the access to health trends among the affected population.

Methodology

The consultant will receive:

IRC’s Patients’ turned-away data.Feedback and complaints received through communications.Exit survey raw data in an excel – questions are open and close ended question.All previous advocacy papers prepared by the IRC for the related topic.The aim of this consultancy assignment is to get a detailed understanding about the effect of the new health policies through an in-depth review of the situation on the ground. Therefore; the consultant must interview the following.

The IRC’s programs beneficiaries: the consultant will interview the beneficiaries through FGDs and in-depth individuals interviews as follows:

4 FGDs in the two urban locations as follows:

– 2 FGDs Male Syrian beneficiaries two per location one for middle-aged adults and one for elderly.

– 2 FGDs Female Syrians beneficiaries two per location one for middle-aged adults and one for elderly.

– 8 in-depth interview with beneficiaries receiving treatment for two of the most common Communicable Diseases – two interviews per location.

Community level health services’ seekers – not using the IRC’s clinics: the consultant will interview the health through FGDs at the community level from the neighbouring areas of the urban clinics follows:

4 FGDs in the two urban locations as follows:

– 2 FGDs Male Syrian refugees one per location one for middle-aged adults and one for elderly.

– 2 FGDs Female Syrians refugees one per location one for middle-aged adults and one for elderly.